Hearing, Language, Speech, Vestibular, and Dentofacial Disorders in Fetal Alcohol Syndrome

Authors

  • Michael W. Church,

    Corresponding author
    1. Depattments of Obstehics and Gynecology (M.WC.), Audiology (M.WC., F.E.), and Otolaryngologv (B.W.B., M.W.C.), Wayne State University School of Medicine and the Mane Carls Communication Disorders Clinic (F.E.) and Division of Genetics (E.V.B.), Children's Hospital of Michigan, Detroit, Michigan.
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  • Frances Eldis,

    1. Depattments of Obstehics and Gynecology (M.WC.), Audiology (M.WC., F.E.), and Otolaryngologv (B.W.B., M.W.C.), Wayne State University School of Medicine and the Mane Carls Communication Disorders Clinic (F.E.) and Division of Genetics (E.V.B.), Children's Hospital of Michigan, Detroit, Michigan.
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  • Brian W. Blakley,

    1. Depattments of Obstehics and Gynecology (M.WC.), Audiology (M.WC., F.E.), and Otolaryngologv (B.W.B., M.W.C.), Wayne State University School of Medicine and the Mane Carls Communication Disorders Clinic (F.E.) and Division of Genetics (E.V.B.), Children's Hospital of Michigan, Detroit, Michigan.
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  • Erawati V. Bawle

    1. Depattments of Obstehics and Gynecology (M.WC.), Audiology (M.WC., F.E.), and Otolaryngologv (B.W.B., M.W.C.), Wayne State University School of Medicine and the Mane Carls Communication Disorders Clinic (F.E.) and Division of Genetics (E.V.B.), Children's Hospital of Michigan, Detroit, Michigan.
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  • This study was supported by the National Institutes of Health Grants P50 AA07606 and R01 DA05536 (to M. W.C.), SP01 CA3838 (to B. WB.), and by a grant from the Neuroscience Program, Wayne State University (to M.W.C., F.E., E.V.B.).

Reprint requests: Michael W. Church Ph.D., Fetal Alcohol Research Center, 275 East Hancock, Detroit, MI 48201.

Abstract

Fetal alcohol syndrome (FAS) is characterized by congenital anomalies traditionally associated with hearing disorders. The present study sought to (a) evaluate possible central hearing loss; (b) verify and extend previous observations on sensorineural and conductive hearing losses; (c) evaluate possible vestibular disorders; (d) examine the relationships between hearing, speech, language, vestibular, and dentofacial disorders in FAS patients; and (e) evaluate the influence of patient age, race, and gender on the expression of these morbidities. A biracial group of 22 FAS patients (aged 3 to 26 years) were evaluated by standard hearing, speech, language, and vestibular tests. Dentofacial and other malformations were also assessed. Of the 22 FAS patients, 17 (77%) had intermittent conductive hearing loss due to recurrent serous otitis media that persisted from early childhood into adulthood, whereas 6 (27%) had sensorineural hearing loss in addition to the conductive hearing loss. Among the 12 patients tested for central hearing function, all (100%) were significantly impaired. Among the patients tested for speech and language ability, 18 of 20 (90%) had speech pathology, 16 of 21 (76%) had expressive language deficits, and 18 of 22 (82%) had receptive language deficits. Hearing, speech, and language deficits were not influenced by age, race, or gender. On the vestibular tests, all performed within normal limits with the possible exception of one child (n= 6). High incidences of dentofacial, temporomandibular joint, ocular, cardiac, and skeletal disorders were observed. Race and gender tended to influence dental malocclusion class. Two subjects exhibited autistic tendencies. In conclusion, new and important findings included a high prevalence of sensorineural, conductive, and central hearing deficits, the persistence of otitis proneness into adulthood, the existence of temporomandibular joint disorders, and the possible influence of gender or race on dental malocclusions. Such disorders can contribute to the learning, behavioral, and emotional difficulties seen in FAS patients and warrant early, aggressive intervention.

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